Pain- and distress-reducing interventions for venepuncture in children.

OBJECTIVE: To compare the effect of eutectic mixture of local anaesthetics (EMLA) and a placebo cream on reported pain and observed distress associated with venepuncture, and to investigate effects of procedural information before and distraction during venepuncture. METHODS: Children 3-12 years of age undergoing venepuncture under five experimental and a control condition reported their pain at venepuncture on visual scales. Distress was observed when the child entered the waiting room, just before, and during venepuncture. RESULTS: Distress increased over the measurement occasions, but a distress-reducing effect of EMLA only was found at the actual venepuncture. The placebo diminished the reported pain, but the effect of EMLA was larger. Procedural information and distraction showed no effects. CONCLUSIONS: EMLA reduces pain from venepuncture. The placebo effect probably results from desirable responding. Behavioural distress is a more direct measure than self-reported pain. More sophisticated designs should be used for the provision of procedural information and distraction.

The contribution of risk factors to the effect of early otitis media with effusion on later language, reading, and spelling.

A cohort of 946 children who were screened for otitis media with effusion (OME) from the ages of 2 to 4 were studied for language, reading, and spelling at 7 years of age. The effects of OME in combination with single risk factors and with increasing numbers of risk factors were investigated. An interaction with an additional risk factor was found only for gender and OME, with boys' spelling influenced negatively by a history of OME. OME in combination with preterm birth and low birthweight also appears to put children at risk for later language and educational problems. Although a negative linear relation between the number of risk factors and later functioning was found, it is suggested that OME, even when combined with a number of other risk factors, produces only minor effects on later language, reading, and spelling.

Long-term effects of ventilation tubes for persistent otitis media with effusion in children.

The otological, auditory and developmental effects of treatment with ventilation tubes were studied in a sample of 7-8-year-old Dutch children screened for otitis media with effusion (OME) serially at preschool age. Children treated with ventilation tubes were matched retrospectively for OME history, sex, and age with children who were not treated surgically. At the age of 7-8, abnormalities of the tympanic membrane were more prevalent in treated than in untreated ears. No significant differences were found in middle ear function and hearing in both groups. Some positive effects of early surgical intervention on specific developmental measures were found.

The effects of early bilateral otitis media with effusion on educational attainment: a prospective cohort study.

The relationship between long-lasting, bilateral otitis media with effusion (OME) between the ages of 2 and 4 and educational attainment, in particular, reading and spelling ability at 7 years of age, was studied in a prospective cohort study of 946 children. After selection, three groups were distinguished: 151 children with long-lasting, bilateral OME at preschool age, 37 preschool children treated with ventilation tubes, and 82 children with no history of OME at that age. Early bilateral OME was found to affect spelling ability, but not reading ability, at 7 years. The effects of OME did not appear to increase with the number of observations of OME. Also, recurrent hearing loss did not have more detrimental effects than continuous hearing loss. Effects of treatment with ventilation tubes were not found. Only the teachers' ratings of writing ability indicated a slight advantage of treatment with ventilation tubes. In conclusion, the educational consequences of early OME appear to be very small.

The effects of early bilateral otitis media with effusion on language ability: a prospective cohort study.

The current study, which is a follow-up on the epidemiological Nijmegen Otitis Media study, examines the relationship between early otitis media with effusion (OME) and later language ability in a group of children with systematically documented bilateral OME. In the Nijmegen Otitis Media study, children were screened using tympanometry at regular intervals of 3 months, between their second and fourth birthdays. At age 7, three groups of children participated in language testing: 82 OME-free children, 151 children with early bilateral OME, and 37 children treated with ventilation tubes at preschool age. A history of OME, even up to nine instances, did not have negative consequences for language performance at age 7. Intermittent, as opposed to more continuous, OME was not found to affect language ability negatively. The suggested benefit of treatment with ventilation tubes was not found.

A comparison of three methods of reading-while-listening.

This study tries to distinguish between the effects of spoken text in reading-while-listening (RwL) and those of text repetition by determining whether repeated RwL of the same text leads to better results than RwL of different texts. Moreover, it is investigated whether the results of RwL can be improved by asking the reader to detect mismatches between written and spoken texts. Subjects were 36 young backward readers (25 boys, 11 girls) from the Netherlands. Mean age was 111 months. With all three methods a practice effect was found for texts as well as for single words. Reading the same text, however, did not lead to better results than reading different texts. Nor were the effects of RwL of different texts improved by mismatch detection. Only the reading speed for the training texts increased following text repetition and mismatch detection.